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How does your form of birth control affect your rate of thrush infections?

Different types of contraception can increase your risk of a thrush infection through physical or hormonal changes. These changes do one or many of the following things:

1. Protect Candida by allowing biofilms so that the body cannot attack it

2. Hormones can affect your immune system functioning (see Immune System)

3. Promote the availability of sugar in the vagina, which in turn feeds Candida. 

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The Coil & Biofilms

Auler and colleagues (2009)  have shown from research on women suffering from recurrent candidiasis that the coil played a role in its development. The IUD structure allowed the formation of biofilms - a protective layer over the Candida structures that prevents the host's immune system from attacking them. It also made anti-fungal drugs less effective. Women choosing the IUD who are prone to thrush should therefore tread very carefully with this form of contraception, with the knowledge that one severe thrush infection could lead to nerve damage. 

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The story however is not entirely clear-cut, as some women report an increase in rates of thrush with their periods. Clinicians then fit the hormonal coil in an attempt to lessen or completely stop periods so the pH of the vagina remains lower and more resilient to Candida albicans. Again, contraception risks and benefits should be discussed with an experienced vulva consultant. 

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Hormonal birth control and the immune system

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Research published in the British Journal of Pharmacology has shown that women using hormonal birth control are at an increased risk of serious infection. Recent studies have also shown its use is associated with the development of autoimmune conditions. Kumwenda et al (2022) found that oestrogen reduced the ability of white blood cells to combat vulvo-vaginal Candida albicans. Women should bear this in mind when choosing a method of contraception. See Immunity section. 

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Furthermore, the prolonged use of contraceptives can lead to vestibulodynia, independent of any nerve damage. In what researchers are describing in the centres of expertise in America: hormonally-mediated vestibulodynia. This is often seen in peri-menopausal or menopausal women and those taking oral contraceptives for a long period of time. These suppressed levels of hormones is thought to affect the integrity of the vestibule tissue, which has a lot of sex hormone receptors. Pain in this case, is usually a constant burn and is improved through the use of topical oestrogen and testosterone cream. To find out if this could be the reason behind your symptoms, you'll need a blood test ordered by your GP or vulva dermatologist. 

 

Oestrogen & sugar

 

Oestrogen in the body leads to an increase in available sugar in the vagina. This is the natural food source of candida and so women on the combined pill could see elevated levels of thrush as its food is more abundant. 

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